Arterial hypertension as a public health issue in the Czech Republic

Hypertension increases the risk of coronary heart disease, stroke, peripheral arterial disease and heart failure. Five independent cross-sectional surveys for cardiovascular risk factors have been conducted in the Czech Republic (1985, 1988, 1992, 1997/98 and 2000/01), always involving a representative population sample aged 25-64 years. Over a period of 15-16 years, there was a statistically significant downward trend in population mean systolic (from 133.6 +/- 20.2 to 128.8 +/- 18.1 mmHg; p < 0.001) and diastolic (from 84.1 +/- 11.3 to 81.4 +/- 10.0 mmHg; p < 0.001) blood pressure (BP). There was also a significant decrease in the prevalence of hypertension in both sexes (from 51.9% to 45.6% in men, p < 0.001; from 42.5% to 33.0% in women; p < 0.001). Awareness of hypertension increased in both sexes, showing higher rates for females (men from 41.4% to 62.1%; p < 0.001; women from 58.9% to 73.8%; p < 0.001). Hypertension control improved significantly over the period of 15/16 years (from 3.9% to 17.9%; p < 0.001), consistently showing more effective control in women. The significant decrease in population mean BP seems to have contributed to the decrease in total and cardiovascular mortality in the Czech Republic observed since 1985.